Trust spending 22% of medical bill on locums

An Audit Office (NIAO) report on ‘The Use of Locum Doctors by NI Hospitals’ shows that by 2017/18 the Western Trust was spending over 22% of its entire medical pay bill on locums.

“Overall, £314 million (86 per cent) of the total £363 million expenditure on locum doctors between 2011/12 and 2017/18 was paid to agencies,” reported the Auditor General Kieran Donnelly, referring to the situation across the North as a whole.

He continued: “Over this period, the ratio of spend on agency locums exceeded 80 per cent in all Trusts, with the Western Trust, at 95 per cent, having the highest dependence on this sector. Furthermore, spend on agency locums increased significantly in all Trusts during this period.”

Mr. Donnelly’s report recognises the challenge Trusts face in reducing locum spend.

“The very high dependence on locums by the Northern and Western Trusts illustrates the particular difficulties they have in recruiting staff in some specialties and grades, and also the limited mobility which is apparent among many local doctors, who prefer to work in the greater Belfast area,” he stated.

The review estimates total expenditure on locum doctors trebled from £28.4m in 2011/12 to £83million in 2017/18 across the North. On a more positive note, while the proportion of spend on non-contracted agencies which charge the highest rates increased in most Trusts between 2013/14 and 2017/18, it actually reduced from 51 per cent to 16 per cent in the Western Trust, where reliance on locums has long been recognised as a structural issue.

“The health and social care sector’s heavy reliance on locum doctors is becoming unsustainable, with rising costs placing local health budgets under huge strain.

“Efforts taken to reduce this dependency have had very limited success. To help ensure that patients’ needs are best met and provide better value for money, it is now imperative that the Department and Trusts collectively progress the transformation agenda and formulate strategies for delivering a suitably resourced and sustainable medical workforce,” said Mr. Donnelly